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Left Ventricular Strain and Relaxation Are Independently Associated with Renal Cortical Perfusion in Hypertensive Patients

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Advances in Medicine and Medical Research

Part of the book series: Advances in Experimental Medicine and Biology ((CLEXBI,volume 1133))

Abstract

Renal perfusion, which depends on cardiac function, is a factor conditioning the work of kidneys. The objective of the study was to assess the influence of cardiac function, including left ventricular contractility and relaxation, on renal cortical perfusion in patients with hypertension and chronic kidney disease treated pharmacologically. There were 63 patients (7 F and 56 M; aged 56 ± 14) with hypertension and stable chronic kidney disease enrolled into the study. Serum cystatin C, with estimated glomerular filtration rate (eGFR), ambulatory blood pressure monitoring, carotid intima-media thickness (cIMT), echocardiography with speckle tracking imaging and the calculation of global longitudinal strain (GLS), diameter of vena cava inferior (VCI), and an ultrasound dynamic tissue perfusion measurement of the renal cortex were performed. We found that the renal cortical perfusion correlated significantly with age, renal function, cIMT, GLS, left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), diastolic peak values of early (E) and late (A) mitral inflow velocities ratio (E/A) and E to early diastolic mitral annular tissue velocity (E/E′), but not with VCI, or the right ventricle echocardiographic parameters. In multivariable regression analysis adjusted to age, only eGFR, E/E′, and GLS were independently related to renal cortical perfusion (r 2 = 0.44; p < 0.001). In conclusion, the intensity of left ventricular strain and relaxation independently influence renal cortical perfusion in hypertensive patients with chronic kidney disease. A reduction in left ventricular global longitudinal strain is superior to left ventricular ejection fraction in the prediction of a decline in renal cortical perfusion.

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Acknowledgments

Funded by grant no 331 from the Military Institute of Medicine in Warsaw, Poland.

Conflicts of Interest

The authors declare no conflict of interest in relations to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Bioethics Committee of the Military Institute of Medicine (No. 35/WIM/2011 of June 15, 2016).

Informed Consent

Written informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland

    Arkadiusz Lubas & Stanisław Niemczyk

  2. Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland

    Robert Ryczek

  3. Department of Radiology, Military Institute of Medicine, Warsaw, Poland

    Artur Maliborski

  4. Department of Gastroenterology, Military Institute of Medicine, Warsaw, Poland

    Przemysław Dyrla

  5. Department of Nephrology, Dialysis and Internal Medicine, Warsaw Medical University, Warsaw, Poland

    Longin Niemczyk

Authors
  1. Arkadiusz Lubas
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  2. Robert Ryczek
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  3. Artur Maliborski
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  4. Przemysław Dyrla
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  5. Longin Niemczyk
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  6. Stanisław Niemczyk
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Corresponding author

Correspondence to Longin Niemczyk .

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Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

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Lubas, A., Ryczek, R., Maliborski, A., Dyrla, P., Niemczyk, L., Niemczyk, S. (2018). Left Ventricular Strain and Relaxation Are Independently Associated with Renal Cortical Perfusion in Hypertensive Patients. In: Pokorski, M. (eds) Advances in Medicine and Medical Research. Advances in Experimental Medicine and Biology(), vol 1133. Springer, Cham. https://doi.org/10.1007/5584_2018_304

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